Mark discusses how medical industries outsource their medical support.
Mark talks about the advancement of personalized medicine. The technology is aimed to monitor compliance and solve several issues when it comes to taking medication. He speaks of the challenges and how these can be solved with the help of nurses based in the Philippines.
This is very, very significant in relation to Digital Medicine and I believe in relation to personalized medicine as well. So in essence, Otsuka have been awarded an NDA, a new drug application for the Abilify medication.
What’s very unique about this treatment is embedded within the pill. Embedded within the tablet is an ingestible sensor. The ingestible sensor when swallowed will send a signal via a wearable patch to an application. The application can now track the compliance of the medicine which it leads to the medical adherence issues being resolved and ultimately it’s going to be a groundbreaking liberation to personalized medicine.
The number of my teams over the last few years have run various projects in relation to this technology and similar content technology. There have been a number of challenges that we’ve had to embrace, that we’ve had to resolve in order to scale a technology.
The first major challenge that we have to address was in relation to the training of the application. So we worked very, very hard to provide very innovative, very well-designed training materials, FAQs. We worked very, very hard to train the primary core teams in the use of technologies. They spent the time with the patients so the idea was that they could do a fantastic job at training the end user.
The reality was that by the time the patient got home, in over 50% of the occasions they’ve forgotten how to use the technology or they have lost the training material. The important thing to remember is that Abilify is prescribed for patients with serious medical illness. In order to resolve the issues, we came up with a support model which comprised of professional nurses based in the Philippines who could spend the time talking to the patients and advising them on how to use the technology in order to help them with their condition.
The second challenge is in relation to medication intake. When the patient is taking the medicine as prescribed, there’s no issue. However when it appears that 10 tablets have been taken at one time, is that a software glitch? Is that an issue as in the patients have flushed the tablets down the toilet? Or is it genuinely the patient has taken 10 tablets? The person who’s on the helpdesk needs to respond to that issue immediately and take the correct actions. In my opinion, that person who responds at the helpdesk needs to be a trained nurse. You cannot use a person in a standard helpdesk to respond to that kind of issue.
The third challenge that we faced was in relation to adverse events. So the patient is trained in relation to contacting the doctor in the event of an adverse event. The reality is, is that the patient when they believe that something has happened, they will contact any number that they have. So we found that in over 50% of the case is the patient would call the helpdesk to report an adverse event. Again, that’s why we need the trained nurse who understands the procedures and can coach the patients and show that the patient contacts the right team for help, but also ensure the correct documentation is followed so that the adverse event is fully documented as well.
My takeaway message is in order to scale this kind of technology, you need a support team who understand the therapeutic area. They understand the patients and they also understand the technology.
In my experience, it’s been very, very easy to train a nurse in the Philippines in the use of the technology. They already have the professional background in relation to the medication. They already have the experience in relation to dealing with patients. It’s a perfect support mechanism for scaling this kind of technology, to ensure maximum compliance, medical adherence and ultimately personalized medicine.